Cold pressure bandage

ABSTRACT

A cold bandage made of various sizes and shapes for application to various portions of the body of a patient, which patient may be either animal or human. The bandage includes outer enclosing means containing at least one bag of volatile refrigerant with an opening in that bag to enhance vaporization of the refrigerant. Where the outer enclosing means are in the form of an envelope, sealed gas tight, with at least one bag opening into the interior of that envelope, the bandage will become inflated by virtue of the refrigerant volatilizing and intimately conform to the portion of the body to which the bandage is applied, thus providing both reduced temperature and pressure. The bandage is highly desirable for use to relieve a traumatized area, reduce inflamatory edema and pain, rapidly decrease hemorrhage, reduce the possibility of infection, minimize tissue damage, and effectively treat burns, among many other applicatory uses.

United States Patent [191 Berndt et al.

[451 Feb. 20, 1973 [54] COLD PRESSURE BANDAGE [76] Inventors: Wilbur C.Berndt; Harry J. Hardenbrook, both of 3419 So. Harlem Ave., Berwyn, II].60402 [22] Filed: May 3, 1971 [2]] Appl. No.: 139,684

Primary ExaminerLawrence W. Trapp Att0rneyl-lill, Sherman, Meroni, Gross& Simpson [57] ABSTRACT A cold bandage made of various sizes and shapesfor application to various portions of the body of a patient, whichpatient may be either animal or human. The bandage includes outerenclosing means containing at least one bag of volatile refrigerant withan opening in that bag to enhance vaporization of the refrigerant. Wherethe outer enclosing means are in the form of an envelope, sealed gastight, with at least one bag opening into the interior of that envelope,the bandage will become inflated by virtue of the refrigerantvolatilizing and intimately conform to the portion of the body to whichthe bandage is applied, thus providing both reduced temperature andpressure. The bandage is highly desirable for use to relieve atraumatized area, reduce inflamatory edema and pain, rapidly decreasehemorrhage, reduce the possibility of infection, minimize tissue damage,and effectively treat burns, among many other applicatory uses.

14 Claims, 17 Drawing Figures PATENTEUFEBZOIBYS SHEET 1 OF 4 I N VENTORS AT 1 ORNEYS PATITNTED 20 5 sum u or 4 INVENTOR5 COLD PRESSUREBANDAGE CROSS REFERENCE TO RELATED APPLICATION This invention is animprovement upon the structure disclosed, described and claimed in ourcopending application entitled Self-Retaining Cold Wrap", filed Apr. 6,1970, Ser. No. 25,969, now issued in US. Pat. No. 3,628,537, dated Dec.21, 1971.

SUMMARY OF THE INVENTION The instant invention includes all of theadvantages of the invention set forth in our aforesaid copendingapplication, but in addition is easier to manipulate, more durable, andprovides a wide selectivity of temperature control. Broadly, allembodiments of the instant invention set forth herein include an outercontainer in which thereis at least one bag for containing a volatilerefrigerant. The bag is made of heat-insulating material, and isselected from several bags of varying heat-insulating capabilities so asto provide a proper degree of coldness when applied to the body of apatient. In one form of the invention the outer container may merely bea wrapping where little or no pressure is needed. In other embodimentsof the invention the outer container is in the form of a compartmentedenvelope-type of container, certain compartments being sealed gas tightto permit expansion thereof when the refrigerant in the bagsvolatilizes, thus providing pressure as well as coldness to the patientsbody. One of the compartments may be left open for added insulation,such as a relatively thick sheet of chemical foam, which is moredesirable when the bandage is utilized on a human rather than an animal,and which is always needed if the ambient air temperature is 45 F. orlower. The refrigerant bags are easily filled with volatile refrigerantand placed in position in the outer container. Suitable fastening meansare provided that are quick acting and capable of holding the bandage inplace until it is intentionally removed notwithstanding ambulation ofthe patient.

Other objects, features and advantages of the invention will be readilyapparent from the following description of certain preferred embodimentsthereof, taken in conjunction with the accompanying drawings, althoughvariations and modifications may be effected without departing from thespirit and scope of the novel concepts of the disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. I is a fragmentary view inelevation of a bandage embodying the principles of the instant inventionand operative in inflated position around the cannon or shank of theleft foreleg of a horse;

FIG. 2 is an enlarged view of the outer face of the bandage itself;

FIG. 3 is a fragmentary view of the bandage looking at the inside orbody contact face, the bandage having been turned over from left toright relatively to FIG. 2;

FIG. 4 is a reduced section through the bandage ready for application toa horses leg, taken substantially as indicated by the section line IV-IVof FIG. 2;

FIG. 5 is an enlarged face view of one of the refrigerant bags utilizedin the bandage;

FIG. 6 is a diagrammatic vertical sectional view, enlarged, and takensubstantially as indicated by the line VI-VI of FIG. 5;

FIG. 7 is a fragmentary sectional view, highly magnified, illustratingthe material of which the bag of FIGS. 5 and 6 is formed;

FIG. S is a view similar to FIG. 6 but showing a bag formed of twothicknesses of material;

FIG. 9 is a view similar to FIGS. 6 and 8 but showing a bag made ofdifferent insulating material;

FIG. 16) is a fragmentary enlargement of the inside face of the materialused in the bag of FIG. 9;

FIG. II is a fragmentary view of a modified form of bandage embodyingthe principles of the instant invention in operating position on theforearm of a human;

FIG. 12 is an outside view in the flat of the bandage of FIG. 11,enlarged, and with parts broken away to illustrate parts therebehind;

FIG. 13 is a view of the inside or body contact face of the bandage ofFIG. llll;

FIG. I4 is a view of the outside face of a bandage for application to ahuman head;

FIG. 15 is a fragmentary view of the inside face of the bandage of FIG.I4, with parts broken away to show parts therebehind;

FIG. 16 is a fragmentary view illustrating the bandage of FIGS. 14 andIS in operative working position upon the head of a patient; and

FIG. I7 is an isometric view of a bandage of still different form butembodying the principles of the instant invention.

DETAILED DESCRIPTION It will be understood that bandages embodying theprinciples of this invention may be made in various shapes and sizes tofit around the particular portion of a body on which treatment isindicated. Therefore, the embodiments of the invention herein disclosedand described are by way of example, and not by way of limitation.

The first embodiment of this invention, described in connection withFIGS. 1410 of the drawings, is one for application to an animal,specifically to a leg of a horse. Over percent of race horses requiredan ice water bath on the forelegs, especially before a race, andsometimes after a race. For many years this was accomplished by anattendant holding the horse with its forelegs in a tub of ice water fora period of l to 3 hours. The wages of the attendant and the ice itselfwere objectionably expensive. The first embodiment of the instantinvention is a highly economical substitute for such procedure, but inaddition to economy, provides the advantages of requiring but a fewminutes time of an attendant, providing moderate pressure on a horsesleg as well as cold, and thehorse is ambulatory while the bandage is on.Consequently, bandages of this character are desirable at race tracks,breeding farms, and substantially anywhere where a number of horses areworked in one way or another.

The first embodiment of this invention comprises a bandage, generallyindicated by numeral 1 and shown in FIG. I in operative position on theforeleg 2 of a horse. The bandage is shown in inflated condition byvirtue of the volatilizing of refrigerant within a sealed compartment inthe bandage. When so inflated, the bandage intimately fits eachvariation in contour or size of the portion of the leg embraced by thebandage.

With reference more particularly to FIGS. 2, 3 and 4, it will be seenthat the bandage 1 comprises a compartmental outside container made upof four sheets of material including an outside sheet'3, twointermediate sheets 4 and 5, and a rear sheet 6. While various materialscould be used for the respective sheets, for abrasion resistance anddurability over a lifetime of repeated usages, the sheets are preferablymade of thermoplastic electronically heat-sealable sheets such aspolyvinyl chloride or other thermoplastic that could be electronicallyheat sealed. The sheets form interior compartments 7, 8 and 9, by virtueof a peripheral heat seal seam l joining all four sheets. A horizontalheat seal seam 11 and spaced vertical heat seal seams 12 define pockets13, l4, 15, 16 and 17 between sheets 4 and 5, which, with the exceptionof the central pocket 15, are accessible through a slit 18 extendingacross the rear portion of sheet 6, and a similar slit 19 extendingacross sheet 5. As seen in FIG. .3, a cross seam 20 closes off access topocket from the compartment 8, and a slit 21, FIG. 2, below that seam insheet 4, permits access to the central pocket from compartment 7. Accessto pocket 15 is by way of an opening 22 in the front panel 3 which, whenthe device is in use, is closed by means of a plastic fastener 23, thecomponent parts of which are heat sealed to the panel 3 around theopening 22 by a seam 24. This plastic fastener is preferably what iscommonly termed a zipper of the type disclosed in Steven Ausnit et al.U.S. Pat. No. 3,054,434, issued Sept. 18, 1962 entitled Bag Fastener.Such a plastic zipper is finger operable but is gas tight.

Means are provided for quickly and securely attaching the bandage arounda horses leg and comprise the plastic strip 25 heat sealed at 26 to thefront panel 3 and which carries a series of spaced eyelets therealong,and a. similar strip 28 which carries hooks for engagement in thoseeyelets projects from the far side edge of the bandage. It will be notedthat the strip 25 is set inwardly from the adjacent side edge of thebandage so that when the hooks are brought around and joined with theeyelets the side edges of the bandage 1 will be brought into abutmentand that abutment will be tight when the bandage is inflated so that thecoldness generated by the bandage will be uniform around the horses leg.

The compartment 7 between the sheets 3 and 4 is completely inflatablebyevaporating refrigerant. Such refrigerant can build up a pressurewhich could possibly reach as high as a 90mm column of mercury persquare inch. While a horse, for example, can stand that pressure in thefetlock or pastern area in case of a fracture, for most injuries,especially the tendons, a maximum pressure of 40-50mm of mercury isdesired. Such lower pressure is maintained by virtue of a known type ofpressure-release valve 30 in the front panel 3, which valve can bereadily adjusted to release gas and maintain the desired pressure.

Refrigerant utilized in the bandage is contained in individual bagsslidable into the aforesaid pockets 13, l4, 15, 16 and 17. While thatrefrigerant could be liquid carbon dioxide, liquid nitrogen, or otherwell known volatile refrigerants, in a proper container or cartridgethat might be dropped into the pocket, for ease of handling andconvenience it is preferred to use solidified carbon dioxide in the formof pellets, premolded or provided by way of crushing or shaving a largerblock of solidified carbon dioxide. Such refrigerant changes from asolid to a gas at a temperature far below zero and therefore sufficientinsulation must be provided to protect the part of the body covered bythe bandage against injurious freezing.

To this end, with reference to FIGS. 5-7, an insulating bag 31 isprovided to contain the refrigerant. It is a simple expedient to formsuch a bag by folding a strip of material along one side and thenstitching the free edges of the folded sheet together across the bottomand up the side of the bag opposite the fold, as indicated at 32,utilizing a binding 33 if desired. The upper end of the bag is left openexcept for a simple form of a snap fastener 34 to prevent accidentalspillage of refrigerant from the bag. The material used for the bag 31is disclosed in FIG. 7 and comprises outer and inner laminations 35 and36 of felt between which is a lamination 37 of gas-porous rubber. Suchmaterial has a high heat insulating value and permits evaporation of therefrigerant not only through the top of the bag but also through theside walls of the bag and time of inflation of the bandage is reduced toa matter of a few minutes.

Where milder cooling of an affliction is desired, a bag 31a, FIG. 8, maybe utilized which is identical with the bag 31, except it is of doublethickness utilizing inside and outside sheets 38 and 39, respectively,of the above described insulating material.

A more economical form of bag 40, FIGS. 9 and 10, may be provided, thebag having the same general structure of the bag 31. The bag 40,however, utilizes a different but highly effective insulating materialin the form of two layers of plastic film one of which is embossed withnumerous trapped air bubbles, as indicated at 41. This material is farmore economical than the material discussed above. The bubbles 41 shouldbe on the inside of the bag, in contact with the CO pellets, thusproviding a temperature in the neighborhood of 23F. on the outsidesurface of the bag. If the smooth face of the material were on theinside contacting the pellets, the outside temperature of the bag wouldbe in the neighborhood of 6F., which is more than desirably cold. Also,with the smooth side of the material on the outside of the bag, the bagis easier to slip into the pockets of the bandage. The material of thebag 40 is not gas porous so the only escape for the gas would be throughthe open top of the bag, and consequently, if bags of this type were theonly ones utilized in the bandage, the time necessary to inflate thebandage would be, in most cases, objectionably lengthy.

Should more insulation be desired, a relatively thick sheet of foamlatex, chemical foam, or similar insulating material may be inserted inthe inner compartment 9 of the bandage, as indicated at 42 in FIG. 4.Usually, in regard to a horse, this sheet of foam material 42 would notbe necessary on summer days, but in the event the ambient airtemperature is 45F. or lower the added sheet 42 should be utilized.

In use, the instant bandage is highly effective and simple to handle. Itis a rapid expedient to fill the five bags this particular bandage useswith pellets of solidified carbon dioxide. The four bags are preferablyfirst placed in the pockets 13, l4, l6 and 17 through the slits in thesheets 5 and 6, as indicated at 43 in FIG. 4. The pellets in these bagswill not inflate the bandage since they will merely gasify into theambient air through the slits by which they were inserted in thepockets. Then, if the zipper 23 is not already open, it should be, andthe other bag of pellets inserted in the pocket 15. The bandage shouldbe lying flat at this time and the zipper may be pressed closed intogas-tight condition with the fingers, and the bandage is thenimmediately wrapped around the leg of the horse, since inflation hasalready started and the bandage must be attached before the bag is fullyinflated. If it is desired or the ambient temperature warrants, the foaminsulating element 42 may be left in the large compartment 9. The bagscontaining the pellets may be inserted into the four rearward pocketswhether or not the element 42 is in position. If that element is not tobe used it should be removed from the container prior to inserting thepellet bags.

If utmost economy is desired, four of the bags 40 may be used in therear pockets, and a bag 31 used in the pocket to acquire more rapidinflation of the compartment 7. Upon inflation, the bandage will beurging moderate pressure against the leg of the horse, and the valvewill prevent pressure from becoming too great. The bandage should beheld on the horses leg in position until it is inflated, at which timethe valve will make a slight hissing noise. The desired degree ofcoldness provided by the bandage can be determined to a satisfactoryaccuracy by the choice of pellet bags and the decision whether or not toutilize the foam insulator While the bandage is in use surface andsubcutaneous temperatures drop slowly. In the area of the horses leg towhich the bandage is shown applied in FIG. 1 surface skin temperaturesafter five minutes of, application drop to approximately 80 andsubcutaneous temperatures drop to approximately 95F. from a start of100F. Surface temperatures slowly decrease over the next 20 minutes intothe 60sF, and subcutaneous temperatures drop to approximately 92F. Aftersubcutaneous temperatures have been plateaued at 92F. approximately 20minutes, a further drop begins at approximately l per minute until asubcutaneous temperature of 58 to 60F. is approached. Surfacetemperatures at that time would be approximately F. When thesubcutaneous temperature reaches 58 to 60F., the temperature stabilizesand remains relatively stable for the duration of the application whichis from 55 minutes to 2 hours in most cases. When it is time to removethe bandage, it is first deflated by either opening the zipper 23 or bypulling out the valve stem after which the bandage can be very easilytaken off.

If it is known that a particular horse is inclined to bother the bandagewhen in use, a stockinet sleeve at least twice as long as the bandagemay be first pulled over the horses leg, and the bandage applied over apart of the sleeve, after which the outer part may be reverted over theoutside of the bandage. If that does not discourage the horsesactivities, a little pepper may be sprinkled on the sleeve and the horsewill leave the bandage alone. Such a sleeve should be used also wherethe bandage is applied for a long period of time, 2 or 3 hours or more,since after that length of time condensation may be formed inside thebandage, and the sleeve will prevent the bandage sticking to the hair ofthe horse.

The bandage will accomplish all of the remedial effects that result froma conjoint application of cold and pressure to an affliction, whicheffects are well known to those skilled in this art. Consequently,should the horses leg be injured to an extent requiring professionalaid, the instant bandage is indicated as first aid procedure whilewaiting the arrival of a veterinarian.

The second embodiment of the instant invention disclosed herein is shownin FIGS. 11, 12 and 13 and is a bandage for application to a human bodyon the leg or arm. In FIG. 11, this form of bandage, generally indicatedby numeral 44, is shown applied to a human arm 45 over the wrist andlower forearm. This bandage 44 also includes four sheets of heatsealablethermoplastic material as above described. These are a front sheet 46, ashorter sheet 47, a third sheet 48 of the same size as the sheet 46, anda shorter inner sheet 49 open at the top to provide a pocket betweenitself and the sheet 48. All the sheets are heat sealed together acrossthe bottom and up the side edges of the container by a seam 50. Thesheet 47 is heat sealed to the sheet 48 by spaced vertical seams 51 toform a series of pockets for the reception of pellet-holding bags suchas the bag 31. The pellets in the bags will ultimately inflate theentire space between the sheet 46 and the sheet 48. That space is closedby a plastic zipper 52 which is the same gas-tight type as discussedabove. Half of this zipper 52a is heat sealed across the top of thesheet 46, while the complemental half 52b is heat sealed across the topof the sheet 48. A pressure-release valve 53 is mounted in the outersheet 46. In this instance, since the bandage is on a human, snapfasteners are sufficient to hold the bandage in position. One series ofsnap fastener elements 54 is carried by a flap 55 extending from a sidemargin of the container, and the other complementary elements 56 arecarried by a flap 57 inset from the opposite side margin of thecontainer and heat sealed along the line 58 to the front sheet 46. Whenthe bandage is placed on the arm of the user, the flap 55 is positionedover the space between the line 58 and the adjacent margin of thecontainer, and the flap 57 is turned to the left of the position seen inFIG. 12 and the snaps engaged, thus bringing the side edges of thecontainer together to insure uniform cooling entirely around the arm ofthe patient.

Any of the pellet-carrying bags 31, 31a or 40 may be used in thisbandage. However, if the bags 40 are selected, but time is of theessence, one of the bags 31 should also be used to provide rapidinflation of the bandage. Also, in view of the fact that human skin isfar thinner than that of a horse, the relatively thick foam insulatingelement 59 should be inserted between the sheets 48 and 49, as seen inFIG. 13, in most all cases.

When inflated, the bandage will follow the exact contour of the part ofthe body around which it is placed, and also apply pressure to that partof the body. Obviously, the bandage will afford relief to burns,sprained ankles, sprained wrists, among other of its many remedial uses.In the case of a fracture, the use of the bandage is clearly indicateduntil a hard cast is applied, although if a bone is merely cracked, thebandage alone may be sufficient to afford adequate relief.

In FIG. 14, 15 and 16 we have illustrated a bandage for application tothe human head. The structure of the container portion of this bandageis substantially the same as that of the bandage described above inconnection with FIGS. 11, 12 and 13. The head bandage includes a frontsheet 60 of the same thermoplastic material mentioned, a shorter sheet61, a sheet 62 of the same height as the sheet 60, and a shorter rear orinner sheet 63 open at the top. lnteriorly, vertical heat seal seams areutilized between the sheets 60 and 61 to provide a plurality of pelletbag-receiving pockets 64. The inflatable space between the sheets 60 and62 is closed at the top by the same zipper 52, a portion of which isheat sealed to each of the sheets, as described above.

For securing the head bandage in position, a headband 65 extending fromboth sides of the container portion of the bandage is provided. Thisheadband is double thickness and preferably formed integrally with thefront sheet 60 and the third sheet 62. In communicates, therefore, withthe inflatable portion between these sheets and so, also, becomesinflated when in use. Snap fasteners or equivalent folding means areprovided on the closed ends of the head bandage, as indicated at 66 inFIG. 14. Also, preferably integral with the front sheet 60 and the thirdsheet 62 at the bottom thereof is a nec-kband 67 which also extends fromboth sides of the container part of the bandage and is provided with asuitable buckle 68 at one end. This neckband, however, is notinflatable, it being cut off from the inflatable compartment by means ofthe heat seal seam joining all the sheets, as indicated at 69.

Owing to the location where the head bandage is applied to the body, theuse of double thickness pellet bags 31a in the pocket 64 is recommended.Also recommended is the usage of the thick foam insulating sheet 70 inthe compartment between the container sheets 62 and 63, thus providingthe maximum amount of insulation. The usual pressure-relief valve 71 ismounted in the outer sheet 60 of the container portion.

In FIG. 16 we have shown the bandage in operative position upon the head72 of a patient. It will be noted that the bandage when inflated,intimately follows the contour of the head and a portion of the neck toapply both cold and moderate pressure thereto. The central portion ofthe body part is of sufficient height to extend around the surface areadirectly rearwardly of the medulla oblongata. It should be further notedthat the bandage on each side extends slightly forwardly of the car downonto the neck so as to overlie the carotid artery and its branches oneach side of the neck. The neck strap rests beneath the chin of thepatient, and the inflatable headband 65 is inflated over a portion ofthe forehead.

This cold plus pressure head bandage is, of course, useful for allinjuries or afflictions to the head where cold and pressure areindicated as a remedy. In addition, it is extremely useful in a numberof cases of headache, such as migraine, the common types of headache,and others that do not require special medication or surgery to relieve.Using the bandage for a common type of headache, should greatly relieveif not eliminate the pain within a few minutes.

The final illustrated embodiment of the instant invention is that ofFIG. 17. This structure requires the use of only one of the pellet bags31, 31a or 40, which bag is filled with pellets and wrapped round andround to provide a few layers of sterile gauze or other sterile fabriccompletely around the pellet bag. It will be noted that the ends of thewrapping project beyond the pellet bag as indicated at 74-74. Doctorsfrequently order the application of cold packs or the equivalent to theperineal area, especially after an episiotomy. The bandage of FIG. 17 isespecially adaptable for that purpose, since the pellet bag and thewrapping raise the temperature developed by the volatile refrigerant toa useful temperature of 28+F. This bandage can easily be placed inposition over the perineal area and held in place by attaching the freeends 74-74 to a sanitary belt. Consequently, the bandage will preventedema, eliminate hemorrhaging and infection, among other reliefs.

All of the embodiments of the invention herein disclosed and describedare flexible and therefore shape themselves in accordance with the bodyarea on which they are placed. Also, all of the bandages provide auseful range of temperatures and the temperature is released at a ratewhere the temperature adaptation mechanism of the body is notoverburdened.

The invention claimed is:

1. In a cold bandage,

a bag for holding a volatile refrigerant,

an outer container for removably covering said bag comprising a sterilefabric wrapped around the bag a plurality of times with the ends of thewrapped fabric projecting freely beyond the bag, and

said bag being of temperature insulating material and open at one end tofacilitate volatilization of the refrigerant.

2. The bandage of claim 1, wherein the material of which the bag is madecomprises a sandwich laminate of felt, gas porous rubber, and

felt.

3. The bandage of claim 1, wherein the material of which the bag is madecomprises two layers of plastic film, one of which is embossed withtrapped air bubbles.

4. In a cold bandage,

an outer container of the compartmental envelopea bag for holding avolatile refrigerant removably disposed in a compartment of said outercontainer, and

said bag being of temperature insulating material and being open at oneend to facilitate volatilization of the refrigerant,

said compartment being inflatable by volatilizing refrigerant.

5. The bandage of claim 4, wherein the compartment nearest the skin of apatient is open at the top, and including a sheet of relatively thickfoam insulation selectively insertable in said compartment.

6. The bandage of claim 4, wherein the outer container has a pluralityof compartments, and including pockets formed in said container each toreceive a refrigerant bag, a gas-tight closure for at least one of saidcompartments, and at least one of said pockets being located in saidclosable compartment whereby the same is inflated by volatilizingrefrigerant.

7. The bandage of claim 6, including a plurality of refrigerant bags ofvarying insulating properties selectively insertable in said pockets.

8. The bandage of claim 6, wherein the closure equipped compartment isfarthest from the skin of a patient when the bandage is applied.

9. The bandage of claim 6, wherein the compartment nearest the skin of apatient is open at the top for the selective reception of addedinsulation.

10. The bandage of claim 6, shaped to fit over the back of a patientshead and upper neck, and including hollow head strap means in opencommunication with the inflatable compartment whereby said head strapmeans are also inflated along with the inflation of said compartment.

11. The bandage of claim 6, shaped to fit over the back of a patientshead and upper neck rearwardly of the medulla oblongata and extendforwardly on each side of the head sufficiently to overlie portions ofthe respective carotid artery and branches.

12. The bandage of claim 11, including head and neck strap means tomaintain the bandage in position on a patient.

13. The bandage of claim 1, wherein said outer container comprises aplurality of sheets of material secured together at least along thebottom and up both sides of the container,

a pair of adjacent sheets being connected by spaced vertical seams toform pockets each removably receiving a refrigerant bag,

the front sheet and an inner sheet forming an inflatable compartment,

gastight closure means affording access to said inflatable compartment,and

at least one said pocket being in said inflatable compartment.

14. The bandage of claim 13, including an open topped compartment beingthe sheet on the patient side of the bandage and the next adjacent sheetto selectively receive added insulation.

1. In a cold bandage, a bag for holding a volatile refrigerant, an outercontainer for removably covering said bag comprising a sterile fabricwrapped around the bag a plurality of times with the ends of the wrappedfabric projecting freely beyond the bag, and said bag being oftemperature insulating material and open at one end to facilitatevolatilization of the refrigerant.
 1. In a cold bandage, a bag forholding a volatile refrigerant, an outer container for removablycovering said bag comprising a sterile fabric wrapped around the bag aplurality of times with the ends of the wrapped fabric projecting freelybeyond the bag, and said bag being of temperature insulating materialand open at one end to facilitate volatilization of the refrigerant. 2.The bandage of claim 1, wherein the material of which the bag is madecomprises a sandwich laminate of felt, gas porous rubber, and felt. 3.The bandage of claim 1, wherein the material of which the bag is madecomprises two layers of plastic film, one of which is embossed withtrapped air bubbles.
 4. In a cold bandage, an outer container of thecompartmental envelope-type, a bag for holding a volatile refrigerantremovably disposed in a compartment of said outer container, and saidbag being of temperature insulating material and being open at one endto facilitate volatilization of the refrigerant, said compartment beinginflatable by volatilizing refrigerant.
 5. The bandage of claim 4,wherein the compartment nearest the skin of a patient is open at thetop, and including a sheet of relatively thick foam insulationselectively insertable in said compartment.
 6. The bandage of claim 4,wherein the outer container has a plurality of compartments, andincluding pockets formed in said container each to receive a refrigerantbag, a gas-tight closure for at least one of said compartments, and atleast one of said pockets being located in said closable compartmentwhereby the same is inflated by volatilizing refrigerant.
 7. The bandageof claim 6, including a plurality of refrigerant bags of varyinginsulating properties selectively insertable in said pockets.
 8. Thebandage of claim 6, wherein the closure equipped compartment is farthestfrom the skin of a patient when the bandage is applied.
 9. The bandageof claim 6, wherein the compartment nearest the skin of a patient isopen at the top for the selective reception of added insulation.
 10. Thebandage of claim 6, shaped to fit over the back of a patient''s head andupper neck, and including hollow head strap means in open communicationwith the inflatable compartment whereby said head strap means are alsoinflated along with the inflation of said compartment.
 11. The bandageof claim 6, shaped to fit over the back of a patient''s head and upperneck rearwardly of the medulla oblongata and extend forwardly on eachside of the head sufficiently to overlie portions of the respectivecarotid artery and branches.
 12. The bandage of claim 11, including headand neck strap means to maintain the bandage in position on a patient.13. The bandage of claim 1, wherein said outer container comprises aplurality of sheets of material secured together at least along thebottom and up both sides of the container, a pair of adjacent sheetsbeing connected by spaced vertical seams to form pockets each removablyreceiving a refrigerant bag, the front sheet and an inner sheet formingan inflatable compartment, gas-tight closure means affording access tosaid inflatable compartment, and at least one said pocket being in saidinflatable compartment.